Healthcare Provider Details

I. General information

NPI: 1396765988
Provider Name (Legal Business Name): NATALIE HARRIS MOBLEY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 W. HURON STREET
ANN ARBOR MI
48107
US

IV. Provider business mailing address

2894 E DELHI RD
ANN ARBOR MI
48103-9007
US

V. Phone/Fax

Practice location:
  • Phone: 734-662-2829
  • Fax: 734-213-0486
Mailing address:
  • Phone: 734-369-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number4704245358
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: